Dr. Gawande is frank and informative about how hard it is to provide high quality care from routine surgery in a United States hospital to emergency care a war zone in the Middle East. He also shares the significant challenges and ethical considerations in certain areas of medicine. While he does not downplay the need for research, he discusses at length the ways in which doctors achieve results above average, sometimes far above average.

Diligence.

Resourcefulness.

Ingenuity.

Determination.

Commitment.

This book is ultimately about being a “positive deviant”, about getting better results than everyone else. But it is not about competition, it is about achieving the best result in a single situation.

Since I read the last page, examples of the very efforts he described seemed to jump out at me. The Minneapolis Star Tribune profiled a local physician’s volunteer effort in “Saving Haiti: One Life at a Time”. This doctor is one of many who choose to do what they can to provide care under difficult circumstances of dirty facilities, inadequate supplies and a seemingly endless need for care.

Also in the Star Tribune was a profile of a local activist who is so committed to reducing the incidence of sexually transmitted diseases in her community that she invited civic leaders and teenagers and everyone in between to her living room for a frank discussion about sex, birth control and STD prevention. “Talking STDs over dinner”. I definitely call that thinking outside the box.

It is easy to look at doctors, social workers and others in the helping professions and expect them to want to do their best to change the world. But I have a less obvious example. My hair stylist.

Bridget has been at the same salon for over 10 years, renting a chair and accepting cash or check for payment. She is always ready for me and always a pleasant person to be around. Every time I sit in her chair, she spends more time carefully cutting, arranging, checking, measuring and double-checking than any stylist ever has. I always leave her chair thinking what a great job she does, every time.

But hair is not all Bridget does well. She has two young sons and spends countless hours volunteering at their school. I know this because I have a child at the same school. She displays that same commitment to quality, same concern for all the kids in the building and support for the school’s staff as she gives me in her chair every six weeks. Bridget makes a difference. She sees where she can contribute and does just that.

We can all make a difference by doing well at whatever it is we spend our time doing. And if you care at all about the quality of your work or the quality of your medical care, this is a must-read.